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J Am Coll Cardiol：辅助性治疗高甘油三酯血症：尚未满足的需求

2018-08-29 佚名 环球医学网

辅助性治疗高甘油三酯血症需求
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尽管二级和一级预防中，高强度他汀在降低动脉粥样硬化性心血管疾病事件中具有重要作用，但持续存在大量的残余风险，尤其在2型糖尿病、代谢综合征和肥胖高风险患者中。发表在《J Am Coll Cardiol》的一项研究表明，在这些高风险患者中，强化降低LDL-C远远不够！

尽管二级和一级预防中，高强度他汀在降低动脉粥样硬化性心血管疾病事件中具有重要作用，但持续存在大量的残余风险，尤其在2型糖尿病、代谢综合征和肥胖高风险患者中。发表在《J Am Coll Cardiol》的一项研究表明，在这些高风险患者中，强化降低LDL-C远远不够！

目前，甘油三酯（TGs）和非高密度脂蛋白胆固醇水平的升高，作为残余动脉粥样硬化性心血管疾病风险的重要介质的作用，被广泛关注，也得到了遗传连锁研究的进一步支持。

既往贝特类、烟酸和大多数胆固醇酯转移蛋白抑制剂（旨在针对高密度脂蛋白胆固醇的升高和/或TG的降低）的试验，未能表现出确凿的证据，即他汀最佳控制了低密度脂蛋白胆固醇水平后，事件增量减少。

虽然ω-3脂肪酸在降低TG水平上是有效的，并且具有多效性效应，如降低斑块不稳定性和动脉粥样硬化的促炎介质，但目前缺乏临床结局数据。在分子水平上，越来越多的证据表明，与DHA相比，EPA对动脉炎症产生更有利的影响。目前，在他汀类药物治疗的ASCVD患者或高风险糖尿病患者中，高剂量（4 g）EPA的长期临床试验即将完成，另一项EPA + DHA试验可能在2019年至2020年结束。

原始出处：
Ganda OP, Bhatt DL, Mason RP,et al.Unmet Need for Adjunctive Dyslipidemia Therapy in Hypertriglyceridemia Management.J Am Coll Cardiol. 2018 Jul 17;72(3):330-343. doi: 10.1016/j.jacc.2018.04.061. Epub 2018 Jun 20.

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    2019-03-04 waiwai3030

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    2018-11-07 仁者大医

    #Cardiol#

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    2019-03-13 flyingeagle85

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    2018-08-31 bioon4

    #高甘油三酯血症#

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